Few could argue that an interdisciplinary team (IDT) approach to patient care isn’t ideal. Representatives from each service providing care for a patient – including physician, nursing, pharmacy, physical therapy, dietary, respiratory therapy, wound care, social work, case management and representatives of other disciplines who may be involved – sit down together and discuss the patient, formulating treatment plans based on the patient's needs and conditions taken together as a whole. The clinicians and staff at Kindred Hospital Clear Lake in Houston, Texas knew how great IDT was, but making it happen wasn’t always easy.

IDT has been an integral part of the hospital’s culture since the facility opened in 2005.

“Early on in implementation, staff didn’t understand the process, they didn’t bring the right information, and didn’t buy into the idea that it’s not just work, but it’s worth the work,” said Dawn Johantges, Chief Clinical Officer of Kindred Hospital Clear Lake. “In the past five years it’s made a big turnaround here and it’s making a huge difference in our patient care.”

“When you have the support of the leadership it makes a huge difference, and Meridell is the glue that holds it together,” she said. “When the captain of the ship thinks something is important enough to be there, it drives the ship where it needs to go.”

Under Sloterbeek’s leadership, the team has taken ownership of the process and comes prepared to the weekly full-day meeting, in which the group, which includes about 12 doctors among its other participants, meticulously reviews its census of about 100 patients.

“The goal is the patient – the patient is the most important member of the team,” said De Harrington, District Director of Case Management for Kindred’s Southwest Region.

The team goes department by department, and room by room, discussing the complex needs of each of the patients.

Areas covered include:

the patient’s current conditions and vitals

goals from a nursing standpoint

antibiotics and infection control measures

nutrition needs

physical therapy progress and goals

respiratory issues and vent weaning

wound care prognosis

social issues and barriers to discharge

“It’s important to hear what others have to say about a patient so you are not working in a silo, inadvertently ignoring things that could be important,” said Johantges. “For instance, I may not know that case management talked to the patient’s daughter, who said something about not knowing how they are going to manage at home, and this is an important social issue for the rest of the team to know.”

Flexibility is key, since the meeting lasts over six hours and participants have other obligations as well.

“Besides admitting patients and working on getting beds, you have your main team in the meeting and others come in and go out as necessary, so they can also get their work done,” said Harrington.

Feedback has been positive.

“The physicians talk about how they learn a lot about clinical issues going on and they can write orders right then and there if necessary which saves time,” said Harrington. “I think that’s why we have so many physicians participate. We have a lot of physician champions.”

And the most important team members – the patients – have been pleased as well.

“We’re fully informing patients of their plans of care and they know what is going on,” said Johantges. “In fact, we invite them to come to IDT meetings if they can and if they come, they have a chance to talk about their expectations and concerns.”

Kindred Hospital Clear Lake was the recipient of a Kindred Guardian Award in April, 2013 for its successful efforts in the area of IDT.